Deutsch S I, Rosse R B, Kendrick K A, Fay-McCarthy M, Collins J P, Wyatt R J
Department of Veterans Affairs Medical Center, Psychiatry Service, Washington, DC 20422, USA.
Clin Neuropharmacol. 1993 Dec;16(6):518-24.
The usefulness of the histamine-2 (H2) antagonist famotidine as an adjunct to conventional antipsychotic treatments of idiopathic psychotic disorders (i.e., schizophrenia and schizoaffective disorder) was investigated in an open-label study. After stabilization for at least 1 week with their conventional antipsychotic medication regimen, 10 patients completed a 3-week study period in which famotidine (20 mg twice a day) was added as an adjunctive medication. The 10 patients were all somewhat treatment refractory and had spent a mean of 230 days of the previous 2 years in the hospital. Total Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression scores were significantly lower during the 3 weeks with famotidine compared with the week before and after its administration. Nevertheless, review of the scores revealed that the magnitude of the changes were small. Negative symptoms as measured by the Schedule for the Assessment of Negative Symptoms (SANS) were not significantly different during famotidine treatment, although there was the tendency for total SANS scores to be lower during famotidine treatment. When BPRS items were divided into specific versus nonspecific symptom subscales, only the specific-item subscales had significantly improved during famotidine treatment. The results of this study suggest that famotidine might prove a useful adjunctive agent in certain patients with schizophrenia. Future studies using a double-blind placebo-controlled design and higher doses are needed. Additionally, other H2 receptor antagonists with better penetration across the blood-brain barrier should be pursued.
在一项开放标签研究中,调查了组胺-2(H2)拮抗剂法莫替丁作为特发性精神障碍(即精神分裂症和分裂情感性障碍)传统抗精神病治疗辅助药物的有效性。在用其传统抗精神病药物治疗方案稳定至少1周后,10名患者完成了为期3周的研究期,在此期间添加法莫替丁(20毫克,每日两次)作为辅助药物。这10名患者均对治疗有些抵抗,在前两年中平均住院230天。与服用法莫替丁前及停药后的那一周相比,在服用法莫替丁的3周内,简明精神病评定量表(BPRS)总分及临床总体印象评分显著降低。然而,对评分的回顾显示,变化幅度较小。用阴性症状评定量表(SANS)测量的阴性症状在法莫替丁治疗期间无显著差异,尽管在法莫替丁治疗期间SANS总分有降低的趋势。当将BPRS项目分为特定症状与非特定症状子量表时,仅特定项目子量表在法莫替丁治疗期间有显著改善。本研究结果表明,法莫替丁可能对某些精神分裂症患者是一种有用的辅助药物。需要采用双盲安慰剂对照设计和更高剂量进行未来研究。此外,应探索其他能更好穿透血脑屏障的H2受体拮抗剂。